I feel that Dr. M has the obligation to inform the facility he is working for of his exposure of HIV and that he is now infected. All patients should be informed of his HIV infections as well. I as a patient having surgery done would want to know if my doctor was infected by HIV and could potentially infect me. I also agree that all pateitns having any kind of surgical procedure needs to inform all healthcare workers that they are infected with the HIV virus. All healthcare workers need to take extra precaution in this situation. I think that it is up to the patient if they would like another doctor to perform the surgery. All patients needs to be informed as well as all healthcare workers need to be informed in my opinion.
I agree with you that Dr. M has the obligation to inform all of his patients and the facitity where he works. Patients I feel should do the same they need to be upfront with their diagnosis of HIV.
I feel the same way. Dr. M should be obligated to inform his patients, IF he were allowed to perform surgery in the first place. I agree that both parties need to be informed about an HIV status if it is going to put someone's health at risk.
I don't know that extra precaution needs to be taken when caring for someone with HIV. One of the many thing that I can remember from nursing school that really stuck with me was an instructor tell us to protect yourself ALWAYS as if every patient you are taking care of has a contagious disease. The best way to protect yourself
I do agree Donna. In the mid to late 1980's I was working in oncology. We had a patient who was end stage multiple myeloma. He had had multiple blood transfusions and we thought he was exhibiting symptoms of AIDS. We wanted him tested for HIV, but the MD asked what we would do differently. He was days away from death and the infectious disease MD who was seeing him said we should take precautions with him, like all our other patients. If I remember correctly he was tested but it stuck with me from them about universal precautions.
I feel that Dr. M has the obligation to let all of his patients know that he is infected with HIV. As a physician he has a duty to keep his patients well informed of risk of any kind. In saying this I think he should still have the right to continue to practice medicine as long as he is upfront and honest with all of his patients and staff members. Now about a patient having HIV I feel the same way. I think they should tell the MD that they have HIV. As a human is the right thing to do.
I have to say I disagree. I don't think a surgeon would be in business very long if he advertised that he had HIV. I don't think it's wrong to keep this information private. If it had to be public knowledge then testing would have to be mandatory and there would have to be some kind of national registry. We treat patients everyday, and I have cared for many that are HIV + just think about all the ones that don't even know their status.
The process of informed consent would include information about the doctor's infection. There are certain precautions that can be taken to avoid mistakes and accidental transmission. We take precautions pre-op and post-op and this is no different. The doctor may perform less surgeries due to his illness and the patient's fear, but their decision will be an informed one.
I agree that it would be a good idea to put it on the consent form, then the patient is fully informed and aware that extra precautions will be taken. I do believe his career will ultimately suffer as a result. Doctors take the chance everyday of being exposed, by choice. I think it is fair to argue the patient has a right to know because they are not willingly taking this risk.
I agree that a surgeon should keep his patient informed, maybe would be a good idea for it to be on the consent. I am not sure how a patient could protect themselves from possible accidental transmission if a surgeon cut himself, other than not letting the infected surgeon operated on them.
Great ideal about putting the information on the consent form. I also agree that that MD should be able to continue to work as a surgeon. We as heathcare workers always use certain precautions for different needs. We are trained to protect our selves and the patients we care for.
Dr.M should refrain from surgery. How can he be acting beneficently if there is even a remote possibly that he could infect his patient with such a critical disease. If it is proven that surgeons due in fact cut themselves and transfer blood to their patients during surgery, then there is no reason he should be performing surgery. Kant believed one should do no harm to their patient, this applies here. If the role was reversed and Dorothea L. was infected, she should definitely have to inform Dr. M of her HIV status. Not to say that he would deny her surgery due to her status, but he could take extra precaution during the procedure.
I am not convinced the surgeon should have to stop performing surgery. I feel if the patient is informed they can decide. I am not sure if the hospital policy would allow him to perform surgery with this type of infection. If they do allow it, then informed consent is absolutely necessary.
Im not sure if the Dr should stop with surgery either. How many people did he already operate on before he even knew he was infected. We all know the disease can hide itself's for years before you even start with symptoms. Should Dr's stop operations if they have HEP B or other diseases that are contagious.
This is a hard topic. I think Dr. M morally should refrain from performing surgery. I think if there is a remote chance of his patient's becoming infected with HIV, he should realize it's time to end his career as a surgeon. I believe that all patient's should be accountable and inform the surgeon of the HIV infection. I think it would be at the discretion of the surgeon if he wants to operate or not.
I am conflicted on this topic. Personally, I would want to know if he were my surgeon if he were HIV+. However, if I were looking at it as just another part of his medical history, I would not feel the need to have all his personal health information (PHI) disclosed to me. That is a violation of his privacy and his PHI. There are many transmissible disease besides HIV that can infect patients. What if he had Hepatitis, C-diff. or MRSA? Should all this be disclosed and should we as consumers have access to all our doctors medical history? I would hope the doctor would feel obligated to share this information, however I do believe people are scared and it would likely be the end of his surgery career. I think as medical professionals, we are at an advantage in that we already know our patients history mostly before we care for them. In the instance that we do not know, I would hope that they would disclose this so extra precautions could be taken . I believe there probably are surgeons operating who already have HIV or Hepatitis and we just don't know. It's a risk every time we consent to surgery.
I agree that there are plenty of surgeons infected with a contagious disease practicing and we don't know. It is their lively-hood and if they disclose this information, more than likely, they would loose their job.
I would like to think surgeons have a sense of obligation that would compel them to disclose any status of HIV, Hep C or any other blood born infection.
I agree with Elizabeth as well, there are many options for physicians, including surgeons, who may be deemed ineligible to operate or perform procedures.
I do not believe that Dr. M has an obligation to refrain from performing surgery. I also do not believe that Dr. M should have to inform his patients that he is HIV positive. If our patients have a right to privacy then the Dr. should too. I do however feel that an infected patient should inform health care professionals regardless if they are having surgery or not. We as professionals need to know to better protect ourselves and the patient.
Dr. M does have an obligation to keep his patients informed of his situation. If there is the possibility of him cutting himself and possible transmission of HIV then he should not be performing surgery. If there is a risky profession that could possibly put someone else at risk for being exposed to HIV the other party needs to be informed. I am not sure that the patient is obligated to inform that they are HIV positive. I was once told by an instructor in nursing school that you should treat everyone as if they have a contagious disease and protect yourself always. If you use universal precaution you will protect yourself from HIV and other possible infections.
Donna I agree as nurses we shold treat every person at if they had a contagious disease that way we are protecting ourselves. So if patients haven't told us everything than we don't have to worry about it if we did what we were suppose to do.
Im torn about this. On one hand I believe that he should inform his patients but on the other i believe that the dr has a right to keep his personal health history private,. There are many other diseases out there that are contangious and can be just as devestating. Hepatitis, MRSA, what if the dr's or even nurses have these diseases should all patients be informed. We all practice universal percautions which is suppose to help protect us. . I think that because the diagnosis is HIV it just makes everybody that much more scared and jugemental. I feel like the patients should tell us and we all deal with them everyday some will tell us everything but there are times when i feel like they are witholding information from us. As I said previously universal percautions was developed for a reason to help protect us.
You have a very good point , Who truly knows what we expose ourselves to on a daily basis , HIV is just one of them, Universal precautions should be followed all of the time.
This is a difficult question to answer. I know that I wouldn't prefer a surgeon that has HIV to operate on me but, I don't necessarily think it ethical that MD have to disclose their personal health information to others if he/she is not “actively” ill at the time the procedure is performed and are practicing universal precautions. I think it’s important for Dorothea L to disclose her medical hx because if a patient is immune compromised the procedure may not be recommended and may cause more harm than help.
Good point Jodi on the patient needing to come forward about her health history because it may have a bigger impact on her overall outcome of the surgery.
I believe that the surgeon should refrain from surgery. If he plans to do surgery he should disclose his infection with the HIV virus. The patient’s medical history is available to the physician and if there is a chance that the patient could be infected, he should make the patient aware. In this instance, the physician should consider utilizing the DaVinci surgical equipment. In the case of Dorothea L, she should notify they physician.
I believe that all of this surgeon patients should know before they have surgery with this doctor that he does have HIV. I also agree with Cindy, the doctor should think about continuing to operate only with the Davinci or other medical equipment so there wouldn't be a risk of him cutting himself and transferring it to patients. Dorothea L should notify the physician. If I was this doctor I think I would stop doing surgeries and focus on doctor appointment work.
Dr. M absolutely has an obligation to inform his patients. When there is a risk a patient will be exposed, they have the right to know. In my mind, there is no grey area here. If we were told we could eat a diet of steak, bacon, butter and sweets and still only have a 0.03% chance of developing heart disease, I bet most of us would be willing take that risk. We as a population view heart disease as affecting the patient only and rarely look at the collateral 'damage'. I believe most of us view HIV as a disease that affects our close relationships. There may be those patients who weigh the skill of the surgeon against the risk of exposure and choose to allow him to operate. The same goes for the patient, Dorothea L. I agree that there may not be any way to take precautions to eliminate all risk of exposure to the surgeon, but if there is an exposure antivirals can be taken to possible avoid conversion.
Hard question, but I don't think Dr. M should have to stop performing surgeries or have to disclose to his patients that he is infected with HIV. If this were the case then it would also have to include any other infectious blood disease. With that being said employers would also have to have yearly blood screenings for HIV or Hep C because think about all the people infected that aren't even aware they have it. As nurses we cannot refuse to treat patients with an infectious disease and we put ourselves at risk. Should a nurse wear a badge with their HIV status because we could have a needle stick and bleed on a patient.
excellent point Shelley , I completely agree that he should not have to stop performing surgeries , although I do feel that his status should be disclosed simply because of the increased risk of transmission in this situation
The physician has a duty to inform the patient in this case just as the patient has a duty inform him. I do not think that Dr. M should be barred from performing surgery , otherwise no surgeon would opt to perform surgeries on HIV positive patients. Extra precautions could be taken to minimize the likelihood of transmission in both of these cases.
I do not believe that the surgeon should have to stop performing surgery or inform the patients of this diagnosis. When we follow universal precautions we are not just protecting ourselves from what the patients have but protecting the patients from what we have as well. Forcing this physician to make this information public would also force all other healthcare workers to make their health history public as well.
Creative alternatives? This surgeon would only operate on HIV+ patients? He learns to operate remotely as someone suggested above? He goes into teaching?
But, if he must quit, who else with what other conditions should quit also?
I believe that the MD should stop performing surgeries. When I have questions regarding actions I take, I like to think of them as a headline in the news. The worse case headline would read that a local surgeon knowingly placed his patients at risk for HIV with each surgery. It would be worse if a patient was actually infected with HIV. I cannot imagine that his malpractice insurance would continue to cover him after that. Nor that the local hospital would allow him to continue to practice in their environment. The case states that there is some risk for exposure to HIV statistically. This numbers implies a small risk. But what if the one case were you or your child. Would the small risk be considered small? If he were able to find alternate means of employment that did not place his patients at risk this would be the best possible solution. I think in the day we live in people would say this wasn't fair for the surgeon. I agree, but also believe that there is no rule to say that life is fair and the greater good should be considered.
I feel that Dr. M has the obligation to inform the facility he is working for of his exposure of HIV and that he is now infected. All patients should be informed of his HIV infections as well. I as a patient having surgery done would want to know if my doctor was infected by HIV and could potentially infect me. I also agree that all pateitns having any kind of surgical procedure needs to inform all healthcare workers that they are infected with the HIV virus. All healthcare workers need to take extra precaution in this situation. I think that it is up to the patient if they would like another doctor to perform the surgery. All patients needs to be informed as well as all healthcare workers need to be informed in my opinion.
ReplyDeleteI agree with you that Dr. M has the obligation to inform all of his patients and the facitity where he works. Patients I feel should do the same they need to be upfront with their diagnosis of HIV.
DeleteI feel the same way. Dr. M should be obligated to inform his patients, IF he were allowed to perform surgery in the first place. I agree that both parties need to be informed about an HIV status if it is going to put someone's health at risk.
DeleteI don't know that extra precaution needs to be taken when caring for someone with HIV. One of the many thing that I can remember from nursing school that really stuck with me was an instructor tell us to protect yourself ALWAYS as if every patient you are taking care of has a contagious disease. The best way to protect yourself
DeleteI do agree Donna. In the mid to late 1980's I was working in oncology. We had a patient who was end stage multiple myeloma. He had had multiple blood transfusions and we thought he was exhibiting symptoms of AIDS. We wanted him tested for HIV, but the MD asked what we would do differently. He was days away from death and the infectious disease MD who was seeing him said we should take precautions with him, like all our other patients. If I remember correctly he was tested but it stuck with me from them about universal precautions.
DeleteI feel that Dr. M has the obligation to let all of his patients know that he is infected with HIV. As a physician he has a duty to keep his patients well informed of risk of any kind. In saying this I think he should still have the right to continue to practice medicine as long as he is upfront and honest with all of his patients and staff members. Now about a patient having HIV I feel the same way. I think they should tell the MD that they have HIV. As a human is the right thing to do.
ReplyDeleteI have to say I disagree. I don't think a surgeon would be in business very long if he advertised that he had HIV. I don't think it's wrong to keep this information private. If it had to be public knowledge then testing would have to be mandatory and there would have to be some kind of national registry. We treat patients everyday, and I have cared for many that are HIV + just think about all the ones that don't even know their status.
DeleteThe process of informed consent would include information about the doctor's infection. There are certain precautions that can be taken to avoid mistakes and accidental transmission. We take precautions pre-op and post-op and this is no different. The doctor may perform less surgeries due to his illness and the patient's fear, but their decision will be an informed one.
ReplyDeleteI agree that it would be a good idea to put it on the consent form, then the patient is fully informed and aware that extra precautions will be taken. I do believe his career will ultimately suffer as a result. Doctors take the chance everyday of being exposed, by choice. I think it is fair to argue the patient has a right to know because they are not willingly taking this risk.
DeleteI agree that a surgeon should keep his patient informed, maybe would be a good idea for it to be on the consent. I am not sure how a patient could protect themselves from possible accidental transmission if a surgeon cut himself, other than not letting the infected surgeon operated on them.
DeleteI agree with you cindy. This should be a part of the informed consent process for this doctor. And I agree with you also donna.
DeleteGreat ideal about putting the information on the consent form. I also agree that that MD should be able to continue to work as a surgeon. We as heathcare workers always use certain precautions for different needs. We are trained to protect our selves and the patients we care for.
ReplyDeleteThe post above was a reply to Cindy's post.
DeleteDr.M should refrain from surgery. How can he be acting beneficently if there is even a remote possibly that he could infect his patient with such a critical disease. If it is proven that surgeons due in fact cut themselves and transfer blood to their patients during surgery, then there is no reason he should be performing surgery. Kant believed one should do no harm to their patient, this applies here. If the role was reversed and Dorothea L. was infected, she should definitely have to inform Dr. M of her HIV status. Not to say that he would deny her surgery due to her status, but he could take extra precaution during the procedure.
ReplyDeleteI am not convinced the surgeon should have to stop performing surgery. I feel if the patient is informed they can decide. I am not sure if the hospital policy would allow him to perform surgery with this type of infection. If they do allow it, then informed consent is absolutely necessary.
DeleteIm not sure if the Dr should stop with surgery either. How many people did he already operate on before he even knew he was infected. We all know the disease can hide itself's for years before you even start with symptoms. Should Dr's stop operations if they have HEP B or other diseases that are contagious.
DeleteKelli: good application of Kant!
DeleteThis is a hard topic. I think Dr. M morally should refrain from performing surgery. I think if there is a remote chance of his patient's becoming infected with HIV, he should realize it's time to end his career as a surgeon. I believe that all patient's should be accountable and inform the surgeon of the HIV infection. I think it would be at the discretion of the surgeon if he wants to operate or not.
ReplyDeleteI agree with you Tricia. This is a very hard topic. If it was me, I would stop performing surgery as well.
DeleteI am conflicted on this topic. Personally, I would want to know if he were my surgeon if he were HIV+. However, if I were looking at it as just another part of his medical history, I would not feel the need to have all his personal health information (PHI) disclosed to me. That is a violation of his privacy and his PHI. There are many transmissible disease besides HIV that can infect patients. What if he had Hepatitis, C-diff. or MRSA? Should all this be disclosed and should we as consumers have access to all our doctors medical history? I would hope the doctor would feel obligated to share this information, however I do believe people are scared and it would likely be the end of his surgery career. I think as medical professionals, we are at an advantage in that we already know our patients history mostly before we care for them. In the instance that we do not know, I would hope that they would disclose this so extra precautions could be taken . I believe there probably are surgeons operating who already have HIV or Hepatitis and we just don't know. It's a risk every time we consent to surgery.
ReplyDeleteI agree that there are plenty of surgeons infected with a contagious disease practicing and we don't know. It is their lively-hood and if they disclose this information, more than likely, they would loose their job.
DeleteI would like to think surgeons have a sense of obligation that would compel them to disclose any status of HIV, Hep C or any other blood born infection.
DeleteI agree with Elizabeth as well, there are many options for physicians, including surgeons, who may be deemed ineligible to operate or perform procedures.
DeleteGood point about those other conditions!
DeleteI do not believe that Dr. M has an obligation to refrain from performing surgery. I also do not believe that Dr. M should have to inform his patients that he is HIV positive. If our patients have a right to privacy then the Dr. should too. I do however feel that an infected patient should inform health care professionals regardless if they are having surgery or not. We as professionals need to know to better protect ourselves and the patient.
ReplyDeleteDr. M does have an obligation to keep his patients informed of his situation. If there is the possibility of him cutting himself and possible transmission of HIV then he should not be performing surgery. If there is a risky profession that could possibly put someone else at risk for being exposed to HIV the other party needs to be informed. I am not sure that the patient is obligated to inform that they are HIV positive. I was once told by an instructor in nursing school that you should treat everyone as if they have a contagious disease and protect yourself always. If you use universal precaution you will protect yourself from HIV and other possible infections.
ReplyDeleteDonna I agree as nurses we shold treat every person at if they had a contagious disease that way we are protecting ourselves. So if patients haven't told us everything than we don't have to worry about it if we did what we were suppose to do.
DeleteIm torn about this. On one hand I believe that he should inform his patients but on the other i believe that the dr has a right to keep his personal health history private,. There are many other diseases out there that are contangious and can be just as devestating. Hepatitis, MRSA, what if the dr's or even nurses have these diseases should all patients be informed. We all practice universal percautions which is suppose to help protect us. . I think that because the diagnosis is HIV it just makes everybody that much more scared and jugemental. I feel like the patients should tell us and we all deal with them everyday some will tell us everything but there are times when i feel like they are witholding information from us. As I said previously universal percautions was developed for a reason to help protect us.
ReplyDeleteYou have a very good point , Who truly knows what we expose ourselves to on a daily basis , HIV is just one of them, Universal precautions should be followed all of the time.
DeleteThis is a difficult question to answer. I know that I wouldn't prefer a surgeon that has HIV to operate on me but, I don't necessarily think it ethical that MD have to disclose their personal health information to others if he/she is not “actively” ill at the time the procedure is performed and are practicing universal precautions. I think it’s important for Dorothea L to disclose her medical hx because if a patient is immune compromised the procedure may not be recommended and may cause more harm than help.
ReplyDeleteGood point Jodi on the patient needing to come forward about her health history because it may have a bigger impact on her overall outcome of the surgery.
DeleteI believe that the surgeon should refrain from surgery. If he plans to do surgery he should disclose his infection with the HIV virus. The patient’s medical history is available to the physician and if there is a chance that the patient could be infected, he should make the patient aware. In this instance, the physician should consider utilizing the DaVinci surgical equipment. In the case of Dorothea L, she should notify they physician.
ReplyDeleteI believe that all of this surgeon patients should know before they have surgery with this doctor that he does have HIV. I also agree with Cindy, the doctor should think about continuing to operate only with the Davinci or other medical equipment so there wouldn't be a risk of him cutting himself and transferring it to patients. Dorothea L should notify the physician. If I was this doctor I think I would stop doing surgeries and focus on doctor appointment work.
ReplyDeleteDr. M absolutely has an obligation to inform his patients. When there is a risk a patient will be exposed, they have the right to know. In my mind, there is no grey area here. If we were told we could eat a diet of steak, bacon, butter and sweets and still only have a 0.03% chance of developing heart disease, I bet most of us would be willing take that risk. We as a population view heart disease as affecting the patient only and rarely look at the collateral 'damage'. I believe most of us view HIV as a disease that affects our close relationships. There may be those patients who weigh the skill of the surgeon against the risk of exposure and choose to allow him to operate. The same goes for the patient, Dorothea L. I agree that there may not be any way to take precautions to eliminate all risk of exposure to the surgeon, but if there is an exposure antivirals can be taken to possible avoid conversion.
ReplyDeleteHard question, but I don't think Dr. M should have to stop performing surgeries or have to disclose to his patients that he is infected with HIV. If this were the case then it would also have to include any other infectious blood disease. With that being said employers would also have to have yearly blood screenings for HIV or Hep C because think about all the people infected that aren't even aware they have it. As nurses we cannot refuse to treat patients with an infectious disease and we put ourselves at risk. Should a nurse wear a badge with their HIV status because we could have a needle stick and bleed on a patient.
ReplyDeleteexcellent point Shelley , I completely agree that he should not have to stop performing surgeries , although I do feel that his status should be disclosed simply because of the increased risk of transmission in this situation
DeleteThe physician has a duty to inform the patient in this case just as the patient has a duty inform him. I do not think that Dr. M should be barred from performing surgery , otherwise no surgeon would opt to perform surgeries on HIV positive patients. Extra precautions could be taken to minimize the likelihood of transmission in both of these cases.
ReplyDeleteI do not believe that the surgeon should have to stop performing surgery or inform the patients of this diagnosis. When we follow universal precautions we are not just protecting ourselves from what the patients have but protecting the patients from what we have as well. Forcing this physician to make this information public would also force all other healthcare workers to make their health history public as well.
ReplyDeleteCreative alternatives? This surgeon would only operate on HIV+ patients? He learns to operate remotely as someone suggested above? He goes into teaching?
ReplyDeleteBut, if he must quit, who else with what other conditions should quit also?
I believe that the MD should stop performing surgeries. When I have questions regarding actions I take, I like to think of them as a headline in the news. The worse case headline would read that a local surgeon knowingly placed his patients at risk for HIV with each surgery. It would be worse if a patient was actually infected with HIV. I cannot imagine that his malpractice insurance would continue to cover him after that. Nor that the local hospital would allow him to continue to practice in their environment. The case states that there is some risk for exposure to HIV statistically. This numbers implies a small risk. But what if the one case were you or your child. Would the small risk be considered small?
ReplyDeleteIf he were able to find alternate means of employment that did not place his patients at risk this would be the best possible solution. I think in the day we live in people would say this wasn't fair for the surgeon. I agree, but also believe that there is no rule to say that life is fair and the greater good should be considered.